NPI | 1659483097 |
---|---|
Former Name | MANDIE MARIE LASSELLE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: ME LC9956) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: ME LC9956) |
Enumeration Date | 2006-08-31 |
Last Update Date | 2011-12-20 |